[Retrospective analysis of the effectiveness of Yokukansan(Japanese Herbal Medicine, TJ-54)in the treatment of delirium following acute stroke].

ABSTRACT

The aim of our retrospective study was to investigate the efficacy and safety of Yokukansan(TJ-54)in treating delirium during hospitalization following acute stroke. We retrospectively analyzed the patients 1)who were admitted to our single stroke center from January 2010 to December 2011 due to acute stroke within four days from onset, 2)who presented with delirium after admission, which was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-IV-Text Revision(DSM-IV-TR)criteria, and 3)who received 2.5g of Yokukansan(TJ-54)three times a day for treating delirium and which was continued until discharge or until onset of adverse effects. We investigated the patient's baseline characteristics, the period of Yokukansan treatment, history of using of another psychotropic drug and complications. We used the Delirium Rating Scale(DRS)to assess delirium state before and at five days after initiation of Yokukansan(TJ-54). We analyzed 77 patients retrospectively. Their mean age was 79.3 years old, and 48 patients(62%)were female. Median DRS score was improved from 15(interquartile range;14-18)to 8(interquartile;6-13), statistically significant(p<0.01)at five days after the initiation of Yokukansan(TJ-54). The median period of Yokukansan(TJ-54)treatment was seven days. There were no patients who received psychotropic drugs or who were suspected of developing oversedation due to Yokukansan(TJ-54). In our study, delirium symptoms following acute stroke improved after Yokukansan(TJ-54)treatment. A randomized controlled trial is needed to establish the effectiveness of Yokukansan(TJ-54)in delirium after stroke.